Maternal history of diabetes is associated with increased cardiometabolic risk in Chinese

Abstract

Objective:Positive family history is associated with increased type 2 diabetes (T2D) risk, and reflects both genetic and environmental risks. Several studies have suggested an excess maternal transmission of T2D, although the underlying mechanism is unknown. We aimed to examine the association between maternal diabetes and cardiometabolic risk in the offspring.Methods:Parental history of diabetes and clinical data including anthropometric traits, fasting plasma glucose and insulin (FPG, FPI), blood pressure and lipid profile were collected from 2581 unrelated Chinese offspring (2026 adolescents from a population-based school survey and 555 adults from a community-based health screening programme). A subset of subjects (n=834) underwent oral glucose tolerance test to measure the glucose and insulin concentrations at 0, 15, 30, 60 and 120 min for evaluation of the areas under the curve (AUC) of glucose and insulin at 0–120 min, homoeostasis model assessment of insulin resistance (HOMA-IR) and bell-cell function, insulinogenic index, insulin sensitivity index (ISI) and oral disposition index (DI).Results:A positive parental history of diabetes was associated with increased risk of obesity (odd ratios (OR) (95% confidence interval (CI))=1.48 (1.10–2.00)), central obesity (OR (95% CI)=1.67 (1.21–2.32)), higher FPI, HOMA-IR, 2-h insulin, AUC of glucose at 0–120 min, triglycerides, reduced ISI and DI. Compared with individuals without parental diabetes, offspring with diabetic mother had significantly increased risk of obesity (OR (95% CI)=1.59 (1.07–2.35)), central obesity (OR (95% CI)=1.88 (1.23–2.88)), higher glucose levels and BP, were more insulin resistant but also had impaired first-phase insulin response and worse lipid profile. However, paternal history of diabetes had no effect on any of the studied traits, except higher body mass index, waist circumference in females and FPG.Conclusions:Our findings suggested that maternal history of diabetes conferred increased risk of cardiometabolic abnormalities, and was associated with both insulin resistance and impaired first-phase insulin secretion. Further investigation into the mechanism of transgenerational diabetes is warranted.

Effect of Family History of Diabetes on Hemoglobin A1c Levels among Individuals with and without Diabetes: The Dong-gu Study

“…One of the reasons for the family history of maternal diabetes is reported more often than family history of paternal diabetes can be a fact that females live longer than males. Although many epidemiological studies have observed excess maternal transmission of diabetes to off-spring, 23 24 25 26 27 a few studies have not reported these findings. 28 29 The Framingham Offspring Study showed that maternal and paternal diabetes equally affect the risk for offspring diabetes; however, those with an mHD were slightly more likely to have increased FPG and abnormal glucose tolerance than those with an fHD.…”

Diabetes in China: Epidemiology and Genetic Risk Factors and Their Clinical Utility in Personalized Medication

“…Studies in the Pima Indian population were among the first to show a high risk of diabetes and obesity among children born to mothers with diabetes (46). Among Chinese adults and adolescents from the community, it was found that a maternal history of diabetes was associated with 59% and 88% increased risk of obesity and central obesity, respectively, as well as more insulin resistance and b-cell function impairment (47), highlighting potential intergenerational effects.…”

The impact of maternal gestational weight gain on cardiometabolic risk factors in children

“…Type 2 diabetes has been recognised as a familial disease transmitted across generations through genetic, epigenetic and environmental circumstances including in utero exposures. To illustrate the role of early-life exposures in programming of disease, previous studies have reported evidence of an excess maternal inheritance of type 2 diabetes and cardiometabolic risk in offspring compared with the pattern of paternal inheritance [ 1 , 2 ].…”